Each fall, ophthalmologists from around the world together with staff members congregate to enhance their knowledge and share experiences at meetings held by the American Academy of Ophthalmology (AAO), its Executive Branch (AAOE) and the Joint Commission on Allied Health (JCAHPO). This year’s meetings were held in New Orleans. Continuing our tradition of enhancing our staff knowledge through continuing education, Dr. Erik van Rens, our Financial Manager, and three of our experienced certified ophthalmic assistants made the trip to take part in this opportunity. We were able to experience a little of the Big Easy outside of class time while interacting with other retina and teaching staff to continue our goal of providing the best in retina care to our patients.
Retina of Coastal Carolina took part in the October 2017 Life Boomers and Seniors Expo held at the Wilmington Convention Center. Our staff greeted attendees, offering free Optical Coherence Tomography screening which was interpreted by one of our retinal physicians. Optical Coherence Tomography (OCT) testing is non-invasive and uses light waves to map and measure layers of the retina. It can provide information to diagnose various diseases of the macula, optic nerve and/or retina.
The Ophthalmic Coding Specialist exam was created by the American Academy of Ophthalmology and tests coding skills in all areas of ophthalmology. We are proud to have two of our staff members, Martha, our Billing Manager, and Heather, COA and surgery scheduler, pass the exam again to retain their OCS designation. The exam is required every three (3) years to assure staff remain up to date on coding changes.
ROCC is also proud that we had three other staff members successfully pass the exam: Janie, our Clinical Manager, as well as April and Kelsey, both COAs who assist with chart documentation for the physicians.
Congratulations to each!
Solar Eclipse Eye Safety
Written by: Kierstan Boyd
Information provided by American Astronomical Society
Reviewed by: Russell N Van Gelder MD PhD
Mar. 06, 2017
A truly awe-inspiring event, a solar eclipse is when the moon blocks any part of the sun from our view. The bright face of the sun is covered gradually by the moon during a partial eclipse, lasting a few hours. During the brief period of a total eclipse when the moon fully covers the sun (only a couple of minutes), the light of day gives way to a deep twilight sky. The sun’s outer atmosphere (called the solar corona) gradually appears, glowing like a halo around the moon in front of it. Bright stars and planets become more visible in the sky.
Watching a solar eclipse is a memorable experience, but looking directly at the sun can seriously damage your eyes. Staring at the sun for even a short time without wearing the right eye protection can damage your retina permanently. It can even cause blindness, called solar retinopathy.
There is only one safe way to look directly at the sun, whether during an eclipse or not: through special-purpose solar filters. These solar filters are used in “eclipse glasses” or in hand-held solar viewers. They must meet a very specific worldwide standard known as ISO 12312-2.
Keep in mind that ordinary sunglasses, even very dark ones, or homemade filters are not safe for looking at the sun.
Steps to follow for safely watching a solar eclipse:
Carefully look at your solar filter or eclipse glasses before using them. If you see any scratches or damage, do not use them.
Always read and follow all directions that come with the solar filter or eclipse glasses. Help children to be sure they use handheld solar viewers and eclipse glasses correctly.
Before looking up at the bright sun, stand still and cover your eyes with your eclipse glasses or solar viewer. After glancing at the sun, turn away and remove your filter—do not remove it while looking at the sun.
The only time that you can look at the sun without a solar viewer is during a total eclipse. When the moon completely covers the sun’s bright face and it suddenly gets dark, you can remove your solar filter to watch this unique experience. Then, as soon as the bright sun begins to reappear very slightly, immediately use your solar viewer again to watch the remaining partial phase of the eclipse.
Never look at the uneclipsed or partially eclipsed sun through an unfiltered camera, telescope, binoculars or other similar devices. This is important even if you are wearing eclipse glasses or holding a solar viewer at the same time. The intense solar rays coming through these devices will damage the solar filter and your eyes.
Talk with an expert astronomer if you want to use a special solar filter with a camera, a telescope, binoculars or any other optical device.
For information about where to get the proper eyewear or handheld viewers, check out the American Astronomical Society.
The Next Total Solar Eclipse: Aug. 21, 2017 across North America
On Monday, Aug. 21, 2017, a solar eclipse will be visible across North America (weather permitting). The whole continent will experience a partial eclipse lasting 2 to 3 hours. Halfway through the event, anyone within a roughly 70-mile-wide path from Oregon to South Carolina will experience a brief total eclipse. At that point, the moon will completely cover the face of the sun for up to 2 minutes 40 seconds.
The last solar eclipse with a path of totality (area where a full eclipse could be seen) was in March, 2016 in Indonesia and some small islands in Micronesia.
After the Aug. 2017 eclipse across North America, the next total solar eclipse will be in South America on July 2, 2019.
A New Supply Office!
Beginning August 1, 2017, our Supply office location will move to 14 Doctors Circle, Unit 4. This is near our old location, but on the other side of the old Brunswick Community Hospital. We are excited to offer a new location for our patients!
To reach the new office from Leland and areas North of Supply, take Hwy 17 South and turn left onto Medical Center Drive. Continue on Medical Center Drive, turning between the two buildings on the right, then left onto Doctors Circle. ROCC is in the corner unit of the building to your left.
From South of Supply, take Hwy 17 North towards Wilmington. Turn right onto Doctors Circle just before your reach the old Brunswick Community Hospital. Retina of Coastal Carolina is in the corner office of the third building on your left.
Specialty Eye Care is also in this location.
Dr. Henry Holt to join ROCC
Twenty years ago Dr. Igor Westra saw the need for an expansion of available retinal care in southeastern North Carolina and founded Retina of Coastal Carolina. The next year he was joined by Dr. Erik van Rens.
Twenty years later, we are happy to welcome Dr. Henry Holt. Dr. Holt recently completed a retinal fellowship at Midwestern Retina/The Ohio State University. His prior training included ophthalmology internships and fellowships in Great Britain followed by an internal medicine internship and ophthalmology residency in New York state.
We are excited to welcome Dr. Holt beginning August 1. He will see patients in all ROCC locations.
A belated recognition of our most recent employee of the quarter. Clayton has an easy going manner and is a hit with patients and co-workers. Clayton joined Retina of Coastal Carolina over a year ago and can handle everything from the initial patient work up and testing to working with the doctor during his examination. He is always willing to offer a helping hand and keeps a positive attitude.
Clayton is an avid diver and plans to take a temporary break from ROCC to pursue his masters in scuba diving. He promises to return in the fall!
A flash of light
Erik van Rens, MD
Last week, I was asked to see a patient as an emergency work-in. She experienced
sudden bright light flashes and floaters.
Once she was in my office I had a chance to listen to her symptoms in more detail.
She had a sudden onset of bright stroboscopic light sensations, followed by seeing
dark spots. These lasted for about 15 minutes, after which they disappeared.
Her symptoms turned out to be related to a fairly common phenomenon called
Most people associate migraines with severe headaches, but often eye symptoms are
the only manifestation of a migraine attack.
These are often very elaborate and can be very frightening, but are harmless.
Patients often see kaleidoscopic patterns with bright colors in a strobe-like fashion.
Sometimes these are followed by blind spots, usually starting in the periphery, but
these can move to the center, blocking vision temporarily. Most attacks last less than
30 minutes, after which vision returns to normal.
This patient could be reassured and she was glad it was not serious.
These flashes are quite different from the symptoms of a more dangerous
phenomenon called vitreous detachment, when the vitreous gel that fills the eye cavity
shrinks and pulls away from the adjacent retina.
This is a process we all will go through, usually as we age, but often earlier in near
These light flashes are very brief, like a shooting star, and are mostly seen in dim or
dark conditions upon eye movements. Ultimately they are followed by the sudden
appearance of floaters, some of which are permanent.
A vitreous detachment happens only once, and is benign in most cases. Sometimes,
however, it is the beginning of a bigger problem, when the gel cannot separate from
the retina and tears it. This will lead to a progressive accumulation of fluid under the
retina, forming a retinal detachment. Usually, the patient is aware of a progressive area
of vision loss, that will get worse until all vision is lost.
A tear in the retina can be treated with laser, and often will prevent the retina from
So, if a sudden onset of bright and brief light flashes, and floaters occur,
visit an eye specialist as soon as possible, preferably with 24 hrs.
Just a Freckle?
Igor Westra, MD
Retina of Coastal Carolina
1801 N.H Medical Park Dr.
Wilmington, NC 28403
Time flies! I didn’t realize that I hadn’t seen Mr. K for about five years. He had been seeing me annually for many years because he had a freckle in his left eye. Recently he had noticed a shadow in his vision. I had a sick feeling in the pit of my stomach when the technician told me of his symptoms. I felt even worse when I saw the photos that he had taken of his left retina. I told the technician to go ahead and do an ultrasound of the eye.
Freckles of the retina are quite common. The medical term is “choroidal nevus” and these are composed of the pigmented cells that grow underneath the retina. The vast majority of these freckles are not dangerous but they may grow slightly and can become darker with age. A small minority, however, become malignant and invade the eye and metastasize to other parts of the body to eventually kill the patient. This is called malignant melanoma and treatment is not very successful.
When a nevus is discovered in a patient’s eye, the doctor typically will get photographs and follow the patient on a regular basis, usually getting photographs each time. If there is any suspicious aspect to the nevus, the patient is referred to the retina specialist. I usually recommend follow up every four months when a nevus is first detected and then after a year, annual exams. In addition to photographs, we may do analysis with ultrasound and sometimes with angiography.
My office usually calls patients to remind them of their appointments. Mr. K had moved and his phone number had changed so he never received the call. He knew that he had missed his appointments but felt that after all these years of follow up his lesion must be benign. Unfortunately it was not.
One option for treatment is radiation to the eye using a special holder that is attached to the eye for two to three days. Pre-radiation a biopsy can be done and sent for analysis and prognostic information. Another option is to cut the tumor out from between the layers of the retina. In Mr. K’s situation the tumor was too large and the eye had to be removed. The tissue showed highly invasive cells and the DNA was consistent with cells that were inclined to metastasize. Nine months later tumors were discovered in his liver and six months later he died.
I tell my patients not to lose sleep over the nevus in their eye but make sure that they keep it checked out. Freckles on the skin that can be watched pretty easily and cut off and sent for testing. The choroidal nevus needs specialized equipment to monitor it and cannot be removed without causing eye damage. Fortunately this is a relatively rare cancer and with early detection the prognosis is good.
Members of our Management Team had the opportunity to attend the 17th Annual ASRS Business of Retina meeting in Dallas, Texas. Kim, Janie and Martha took advantage of this yearly opportunity to attend sessions and have discussions with other practices devoted solely to the diagnosis and treatment of issues related to the Retina subspecialty. The American Society of Retina Specialists sponsors this one and a half day session every spring, utilizing members’ expertise as well as those of various outside experts. It provides the opportunity to remain up to date, as well as network with other retina leadership. We learn together, commiserate together over constantly changing governmental regulations, anguish over obstacles to patient care by insurers as well as deal with the ongoing challenges of running a business. Thanks to our physicians for this opportunity.